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General NPI Number Information
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NPI Number | 1457805855
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Entity Type | Individual
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Provider Name | YI-CHUN CHENG
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 3006 SAN GABRIEL BLVD
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City | ROSEMEAD
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State | CA
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Zip | 91770-2536
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Country | US
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Telephone | 626-773-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 121 AUTUMN OAKS LN
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City | GLENDORA
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State | CA
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Zip | 91741-6613
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Country | US
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Telephone | 626-731-1491
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95004654
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License Number State | CA
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